P811 A watchful approach for newly diagnosed Crohn’s disease patients with an inflammatory phenotype
S. Yassin, N. Fliss-Isakov, Y. Ron, A. Hirsch, N.A. Cohen, N. Maharshak
Tel Aviv Sourasky Medical Center, Gastroenterology Unit, Tel Aviv, Israel
Background
Early treat-to-target approach in Crohn’s disease (CD) patients is recommended to avoid complications. However, CD may not progress in all patients, despite lack of treatment or 5-ASA medications use, exposing this group of patients to unnecessary side effects if treated according to guidelines. We aimed to examine whether newly diagnosed CD patients with an inflammatory phenotype can benefit from a watchful approach.
Methods
This was a retrospective cohort study following CD patients at a tertiary centre, who were diagnosed between 2010 and 2015 and were followed for at least 1 year. Only patients with an inflammatory phenotype (Montreal classification B1) were included. Epidemiologic, clinical and endoscopic data was retrieved from medical records. A watchful approach was defined as maintenance therapy with 5-ASA medication only or no treatment at all during first year of diagnosis or further. Disease complications were defined as surgery or change in disease phenotype.
Results
Thirty-seven patients, (35.1% males at a mean age of 41.4 ± 19.6 years) were included in the study. During the follow-up period of 54.9 ± 28.7 months, 31 patients (86.0%) did not develop disease complications. The patients were characterised by females predominance (83.3% vs. 25.8%,
Conclusion
A watchful approach of newly diagnosed CD patients with an inflammatory phenotype can be considered, especially in non-smoking women. This sub-group should be further characterised.